Sunday, February 01, 2009

The Difficult Case of the Octuplets by Anthony McCarthy

Since I haven’t heard it mentioned yet, first, let’s not forget the sperm donor’s role in this, he also must bear responsibility and his choice questioned.

The case of the octuplets born this week brings together of many troubling and conflicting issues. Reproductive rights meets medical malfeasance meets mental health issues, personal responsibility, societal responsibility, .... Like it or not, this case will increase the willingness of many people to find a limit to what in normal circumstances should be a personal affair and a personal right. The situation is not normal or natural, it is an artificial birth, man made, the result of conscious choices and unnatural technology. The results create an unavoidable mess. And what a mess it is. I wonder if the artificial and commercial aspects of this don’t make it a qualitatively different political issue from other kinds of birth. Asserting that this is a private decision of personal choice, is only to willfully ignore that it isn’t an issue of solely personal consequence.

The issues surrounding the choices and desires of the mother are the most difficult since many of those are normally not anyone’s business but hers. But those choices not only impact the broader society in terms of support for children she won’t be able to support, their medical care and likely continuing needs they also open those choices to comment on whether or not the inherent rights of the children are damaged. Parents are held to be responsible for their behavior towards their children. If they are unwilling or unable to act responsibly or act in ways that harm their children, they should lose some if not all of their rights to them. They also are held financially responsible for children they produce, unless they allow other parents to take the full responsibility for the children.

The dangers of multiple births are an aspect of this as a legal and political issue. When that is an avoidable issue, it becomes a matter of the personal responsibility of the adults making those choices. The mother’s decision to be implanted with these eight embryos was irresponsible due to the likely consequences for the health of the resulting children. As uneasy as I feel saying it, it was selfish. Her children have a right to the support of society, they also have a just claim on her, the sperm donor, the fertility doctors and others who made their birth possible. If the children produced in this mega-multiple birth have severe health problems, it will be much more difficult to find adoptive parents who will be willing to take those responsibilities.

Then there are her other children’s needs which will, very likely, eventually need to be met by society too. When does the size of a family cease to be only a personal decision? The answer that it is never the business of the public at large won’t be accepted by many people, whether or not it should be. Like it or not, this will be discussed and considered, it will influence peoples’ political choices.

But the decision to implant the embryos was not hers alone. She wouldn’t have been able to do it without a large number of other people, doctors, technicians, likely administrative staff, insurance personnel. Those choices are an aspect of commerce, the professionals involved almost certainly didn’t do it for nothing. The fertility industry wouldn’t exist without money being paid. As such, their actions are legitimately subject to governmental and public oversight. Given the danger to the mother and the resulting children, all of them should be investigated for possible negligence and irresponsibility.

The fertility industry can help people who have trouble conceiving a child produce a family. While I’m inclined to wonder at the wisdom of that in a world with so many orphaned and neglected children, having a child is a right. Producing six by artificial means, I have an increasing problem with that, though I don’t think it should necessarily be a matter of law to restrict it. But this issue doesn’t only involve the relatively safe births of individual children through artificial means. These mega-pregnancies are both dangerous and unnatural. The serious impact on the rights of each of the individual children born and also to the mother’s health make this an essentially different matter. The commercially irresponsible acts of the fertility industry in this makes you wonder how it differs from commercial breeding of farm animals. That’s an outrageous comparison, but it’s a pretty outrageous act for them to make this kind of thing happen. What are we supposed to make of “healthcare” professionals that knowingly engage in activities that carry such a high probability of harm to their clients? That list of clients must also include the children its in the business of producing, not just the adults who initiate the process. The fertility industry should pay the costs of their choices.

When health care knowing produces medical catastrophes, when it makes a high risk gamble on that happening, legal regulation isn’t only justified, it is a necessity.